HSE challenging St Joseph’s admissions ban

THE Health Service Executive (HSE) has confirmed it will challenge efforts by the independent health watchdog HIQA to impose restrictions on new admissions to St Joseph’s Geriatric Hospital in Ennis.

HIQA is on a collision course with the HSE over regulatory issues at the hospital, which provides vital public step-down facilities to elderly people.

The Clare Champion has learned that admissions will continue at St Joseph’s, pending the outcome of a court appeal being prepared by the HSE.

A SIPTU spokesman told The Clare Champion that its members have been providing the best quality care to patients in St Joseph’s.

The spokesman explained the regulatory issues do not cover patient care but moreso difficulties in relation to the physical infrastructure, which HIQA have been highlighting for some time.
Over the last three years, he said there have been plans to carry out remedial works at St Joseph’s, as well as an overall plan to construct a new facility on the grounds.

“SIPTU is calling on the HSE to secure the necessary funding to carry out these works as quickly as possible, to ensure the future of patients and staff are protected,” he added.

Deputy Timmy Dooley, concerned that an admissions ban may be imposed at St Joseph’s Hospital. Photograph by John Kelly.

Deputy Timmy Dooley stated it has been brought to his attention that there are some issues that may prevent any further admissions at St Joseph’s.

He warned if this is implemented, it will put acute facilities in Ennis Hospital and University Hospital Limerick (UHL) under significant strain, as St Joseph’s acts as an effective step-down facility for the transfer of patients out of hospital. He said he hopes the HSE and HIQA can resolve any outstanding issues to ensure a continuation of service.

In a statement to The Clare Champion, the HSE confirmed it has been notified by HIQA that a decision was taken to impose a condition on the registration of St Joseph’s Hospital.

“The condition is one which would stop all admissions other than the rehabilitation unit and one other area of the hospital. This decision has not yet taken effect and the HSE has appealed it.
“When the HSE are in a position to provide further information, the HSE will assure the public the authority are doing everything to avoid such an outcome. As of Wednesday, the HSE continues to be able to admit people to St Joseph’s,” said a HSE spokesman.

HIQA confirmed it is engaged in ongoing regulatory action with the HSE, but a spokeswoman told The Clare Champion it would not be making any further comments at this time.

“HIQA doesn’t generally comment on individual centres, as the reports speak for themselves,” said the spokeswoman.

St Joseph’s was found to be non-compliant in terms of accommodation after a 2015 HIQA inspection.

According to an inspection report, patients were complimentary of staff but consistent areas of concern/dissatisfaction were identified, such as the physical environment, meaningful engagement and staffing levels.

“Patients articulated a clear desire for more privacy, more space, more sanitary facilities and somewhere to meet up and chat. Residents wanted more meaningful engagement and reported that they ‘had nothing to do’; this was also reflected in some of the relatives’ questionnaires,” the report noted.

Concerns were raised as to the impact of staffing on residents’ choices and routines, such as their personal hygiene, access to snacks and fluids and having to wait for “long periods” for staff assistance.

HIQA stated the findings of this inspection supported and reflected the majority of these experiences.

There were 120 registered beds in the centre on the days of inspection, 98 of these beds were occupied, 80 on a long-term basis and the remainder occupied by residents in receipt of short-term and respite care.

Staff had assessed the needs of the majority of the residents (81) as of maximum dependency.
Inspectors reviewed the premises, met with management and staff and spoke with residents and relatives throughout the inspection. Inspectors observed care and practice and reviewed records pertaining to nursing and medical, fire, health and safety, accidents and incidents and complaints.

Overall, inspectors were satisfied that the centre was well governed and systems were in place for the ongoing review and monitoring of care and services. The maintenance of adequate staffing and skill-mix was described as “challenging” but inspectors were satisfied that this was managed proactively by the person in charge and the provider.

Arrangements were in place to meet the healthcare needs of residents and improvement was noted, though more was required in the provision of meaningful activities.

“The premises is significantly non-compliant with regulatory requirements and does not meet the individual and collective needs of the residents in terms of their privacy, personal space, access to dining and communal space and adequate and accessible sanitary facilities,” the HIQA report stated.